Vitamin D Deficiency and Clinically Detected Scoliosis among Male Adolescents at High-Altitude Area in Southwestern Saudi Arabia

Abdullah Assiri; Ahmed A. Mahfouz; Nabil J. Awadalla; Ahmed Y. Abolyazid; Medhat Shalaby

doi:10.3889/oamjms.2020.4347

Authors

Abdullah Assiri Department of Internal Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
Ahmed A. Mahfouz Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt
Nabil J. Awadalla Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; Department of Community Medicine, College of Medicine Mansoura University, Mansoura 35516, Egypt
Ahmed Y. Abolyazid Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; Department of Community Medicine, College of Medicine Mansoura University, Mansoura 35516, Egypt
Medhat Shalaby Abdullah Assiri; Department of Rheumatology, Faculty of Medicine, Al Azhar University, Cairo 11651, Egypt

DOI:

https://doi.org/10.3889/oamjms.2020.4347

Keywords:

High altitude, Adolescents, Vitamin D deficiency, Clinical scoliosis, Saudi Arabia

Abstract

BACKGROUND AND OBJECTIVES: Reports suggest that Vitamin D deficiency (VDD) is common and is a general health challenge worldwide and at high altitude in particular.

AIM: The objectives were to explore Vitamin D status, to examine the association of VDD and clinically detected scoliosis, and to find a cutoff point of Vitamin D level predicting clinical scoliosis in Abha City (high-altitude area).

METHODS: A nested case–control design was conducted among a screened population of 417 male adolescents from intermediate and secondary schools in Abha City, Southwest Saudi Arabia. From the surveyed adolescents, 62 cases with clinically detected scoliosis and 205 age-matched controls without scoliosis were selected. For both groups, serum level of 25-hydroxyvitamin D was assessed by standardized technique.

RESULTS: More than two-thirds (68.5%) of male adolescents suffered from VDD (<25 nmol/L). The risk of clinical scoliosis was significantly higher among adolescents with VDD compared to those without deficiency (grade adjusted odds ratio = 6.88, 95% CI: 2.63–17.99). Receiver operating characteristic curve analysis showed acceptable discriminative ability of serum Vitamin D (area under the curve = 0.702) to predict scoliosis at a threshold value of ≤20.2 nmol/L.

CONCLUSIONS: Overall levels of Vitamin D in the study adolescents suggest a high prevalence of VDD at high-altitude area in Southwest Saudi Arabia. There is evidence for a positive association between VDD and clinically detected scoliosis. A threshold cutoff value of 20.2 nmol/L has been identified to predict clinically detected scoliosis. The role of possible preventive effect of Vitamin D supplementation should be considered by school health authorities.

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